The shoulders are essential parts of the body. They have a wider range of movement than any other joint. If you are experiencing so much pain that you cannot reach into the wardrobe, have trouble falling asleep, or are experiencing other problems, your physiotherapist could recommend a shoulder replacement procedure. Physical therapy for shoulder replacement (arthroplasty) aims to improve your shoulder's strength, overall function, and range of motion while alleviating pain.

We at Suarez Physical Therapy can help you resume regular activities following a shoulder replacement operation. Our medical professionals can also help enhance your quality of life by providing patient education, prescribed mobility, and hands-on treatment. You can schedule an evaluation with one of our Las Vegas physiotherapists.

Understanding Shoulder Arthroplasty

Arthroplasty, or shoulder replacement, is a type of surgery used when alternative treatments, like physical therapy or medicine, have failed to manage or alleviate pain. Your surgeon can also consider arthroplasty when the shoulders are no longer functional. A consultation with your orthopedic surgeon can help you determine whether or not to proceed with this procedure.

Conditions That Require Shoulder Replacement

The most common conditions that result in shoulder replacement include:

  • Osteoarthritis—Osteoarthritis, also known as wear and tear arthritis, causes deterioration to the cartilage that protects the tips of bones and allows joints to move smoothly.
  • Rotator cuff injuries—A rotator cuff is a collection of tendons and muscles surrounding the shoulder joints. Rotator cuff injuries occasionally cause cartilage and bone damage in the shoulders' joints.
  • Fractures—It could be necessary to replace a broken or damaged upper humerus bone if the original surgical procedure to treat the fracture was unsuccessful.
  • Various inflammatory conditions, including rheumatoid arthritis. Rheumatoid arthritis inflammation, caused by overactive immune systems, can destroy the joint's cartilage and, in some cases, the underlying bones.
  • Osteonecrosis—Some shoulder disorders can disrupt blood circulation to the humerus. Bones can collapse if they do not receive enough blood.

Procedures For Shoulder Replacement

Shoulder arthroplasties are classified into three categories. The following are some of the shoulder replacement alternatives that your doctor could recommend, depending on the severity of your joint damage:

  1. Total Shoulder Replacement

The procedure involves removing and replacing two shoulder bones with artificial implants. The upper section of the shoulder bone resembles a ball. It is known as the shoulder's "head." The shoulder joint forms when the head rests on a little socket on the shoulder blade. During a total shoulder replacement surgery, the head is substituted with a metal ball implant. A tiny dish-shaped cup stands in for the socket.

  1. Reverse Total Shoulder Replacement

In this surgery, the surgeon reverses the socket and ball joint. Medical professionals recommend this operation when the shoulder's rotator cuff muscles have been damaged. The plastic implant is secured to the upper part of the shoulder bone, while the ball-shaped metal implant is fitted to the socket. It facilitates the movement of the deltoid, which is an additional shoulder muscle. The deltoid muscle compensates for injured rotator cuff muscles. Reverse total shoulder replacement can help enhance your shoulder's strength, stability, and range of motion.

  1. Shoulder Hemiarthroplasty

This replaces only a portion of the shoulder. The surgical procedure involves the replacement of the arm bone's head with a ball-shaped metal implant.

Risks of Shoulder Arthroplasty

Although rare, shoulder replacement cannot alleviate or eliminate your pain. The procedure may not restore the joint's movement and strength. In some circumstances, your surgeon can recommend additional procedures. Potential consequences of shoulder arthroplasty surgery include the following:

  • Dislocation—There is a likelihood that the ball in your replacement joint can pop out of its socket.
  • Fracture—The humerus, scapula, or glenoid bones can all fracture after or during the operation.
  • Implant loosening. Although shoulder replacement parts are long-lasting, they could loosen or wear over time. In rare situations, you could need another operation for the replacement of the loose parts.
  • Failure of the rotator cuff—Occasionally, following either a partial or complete surgical shoulder replacement, the rotator cuff, the group of tendons and muscles surrounding the shoulder joints, wears down.
  • Damage to the nerves—Implant placement poses a risk of nerve injury. The injury can result in weakness, pain, and numbness.
  • Blood clots—A person can develop clots in their arm or leg veins after surgery. This is harmful because pieces of the clot could break off and move to the heart, lungs, or, in rare cases, the brain.
  • Infections—These can occur at the surgical site or deeper within the tissues. Surgery could be necessary to deal with the infections.

Evaluation for Physical Therapy

A physical therapist will provide an initial evaluation during your first visit following a shoulder replacement. During this visit, the physiotherapist will inquire about your daily routine, shoulder condition, and medical records. They can conduct several evaluations and tests, such as:

  • Range of motion.
  • Pain assessment.
  • Strength evaluations.
  • Examine the scar tissue from your surgery.
  • Touching, also known as palpation.
  • Functional assessment.

Once your physiotherapist has established an overview of your present functional abilities and weaknesses, they will walk you through the next steps in your rehabilitation. These steps can include preparing a care plan and setting targets.

The common goals following shoulder replacement surgery could involve the following:

  • Restore your range of motion and flexibility.
  • Regain complete control and strength of your arm and shoulder.
  • Eliminate pain.
  • Maintain regular arm function while performing tasks or engaging in activities.

Your rehabilitation goals after shoulder replacement could vary slightly. Therefore, consult with your physiotherapist to establish realistic and detailed goals. Once you have established your targets and devised a strategy, you can start your shoulder physical therapy program.

Significance of a Physical Therapist in Shoulder Arthroplasty

Physical therapy is essential for a healthy and secure recovery following shoulder replacement. If you have undergone shoulder surgery, a physical therapist can help you enhance your shoulder functions and reduce pain as you recover. Your physical therapist will safely guide you to return to your previous activity levels and rebuild your strength and mobility.

The main objective is to help you regain your ability to perform regular household chores, employment duties, and leisure activities. A physical therapist can also assist you in preparing the shoulder for the operation.

How a Physical Therapist Can Help Before and After Surgery

During the various stages of the procedure, your physical therapist can help in the following ways:

  1. Before Surgery

It is ideal to see a physical therapist before surgery. If the shoulder is in good shape before surgery, you'll have a better chance of fully recovering. Your physiotherapist will design a program specifically for you. The program can entail exercises for strengthening the shoulders, back, and neck muscles. Stretching and posture exercises could also be part of the pre-surgery routine.

If you are using prescribed opioids, consult with your orthopedic surgeon about reducing them before your operation. Also, ask the physiotherapist how they could assist you in managing pain before the operation. Patients who take opioid drugs for pain management before surgery had poorer results than those who don't.

  1. During Surgery

After a shoulder replacement surgery, you will likely undergo a variety of treatments as part of your rehabilitation. These could involve physical modalities as well as movements such as exercise.

Modalities

Your physical therapist can use a variety of techniques to increase blood circulation and reduce pain following shoulder replacement surgery, including:

  • Ice application—This method helps to ease pain while also controlling inflammation and swelling.
  • Heat application— This can help to relax the muscles and relieve pain. Heat could also increase blood circulation to the shoulder's tissues.
  • Electrical stimulation, such as TENS, can be used to alleviate pain. Neuromuscular electrical stimulation (NMES) is a type of electrical stimulation that can help the muscles to contract correctly following surgery.
  • Kinesiology Tape—This helps to relieve discomfort and swelling while improving the muscular performance of the shoulders.

Many physical therapists choose not to use physical modalities as a treatment option. There is a belief that creating a reliance on physiotherapists develops a bond with patients. However, research suggests that shoulder replacement methods do not improve functional outcomes.

  1. After Surgery

Following your surgical procedure, you will most likely stay in the hospital for 2 or 3 days. If you suffer from any other illnesses, like heart disease or diabetes, your doctor could extend your hospital stay. Depending on the surgeon's instructions, the shoulders will remain in a sling for 3 to 8 weeks. You are not allowed to move the shoulders while dressed in the sling. Your physiotherapist can offer additional dos and don'ts to speed up your recovery.

Physical therapy begins within a day or two after the procedure. The hospital's physiotherapist will show you how to do specific workouts and basic tasks. Additionally, you will be instructed on the movements and activities to avoid.

Your physical therapist could show you how to perform the following tasks:

  • Safely get into and out of bed.
  • Remove your sling and put it back on properly.
  • Put on your clothes while maintaining a safe shoulder posture.

If you have any queries regarding what to do or not do when you return home, inquire about them. These inquiries could include ways to manage post-surgery pain and edema with ice.

A physical therapist can also teach you simple workouts to reduce stiffness and help in recovery. During the first few weeks or days, you will need assistance with daily tasks from family or friends. While recovering from surgery, you won't be able to operate a vehicle.

Avoid alcohol and tobacco use to aid post-surgery healing. If you have diabetes, you can consult your physician to manage glucose intolerance.

Recovery Period

Maintaining physical therapy sessions is crucial after discharge from a medical facility. Your physical therapist and surgeon will work together to ensure a smooth recovery. Consult with a physiotherapist to determine the appropriate balance of rest and workout.

Usually, a physical therapist will recommend different workouts for specific areas following surgery. They can show you what is appropriate at every recovery phase.

The treatment plan could include the following:

  • Range-of-Motion Workouts

During the first 2 to 6 weeks following surgery, you should avoid making any sudden or forceful shoulder movements. Your physiotherapist will help you heal by gently moving the shoulder in various directions. These could be active motions you make on your own or passive motions the physical therapist performs.

Also, the physical therapist can review some easy exercises you can do on your own time. You can also practice range-of-motion workouts for your hand and elbow to reduce stiffness when wearing a sling.

  • Strengthening Workouts

You can initially squeeze a putty or a ball to help maintain a firm grip while using a sling. You are expected to regain mobility in a few months or weeks. A physical therapist can guide you through shoulder-strengthening exercises to help you recover your strength. When the time comes, your physiotherapist can recommend that you practice gentle strength-building workouts using weights and resistance bands.

  • Functional Training

A physical therapist can assist you in regaining normal shoulder mobility. They will educate you on safe methods while engaging in activities vital to your self-care. Before you begin physical therapy, you should be sure that your physiotherapist knows which issues matter most to you. They will customize your treatment plan to meet your individual needs.

  • Training Specific To a Job or Sport

As your mobility and strength improve, your physical therapist can develop a personalized plan to assist you in returning to work. These can involve pushing, reaching, and carrying activities. You could also receive sport-specific workouts if you intend to resume a sport. Your physiotherapist will design a workout plan for you at home or in a fitness center based on your needs.

Caution with Reverse Shoulder Arthroplasty

Your physical treatment regimen could involve rotator cuff workouts if you have undergone standard shoulder replacement surgery. However, if you have undergone a reverse shoulder replacement, you should avoid these exercises. Since there are no rotator cuff muscles, you should focus on developing the deltoid muscles to assist your arms to move appropriately. You should avoid movements that cause the shoulders to spin externally to their end range.

Can This Condition or Injury Be Avoided?

Shoulder arthroplasty is often an elective procedure. If your shoulder hurts and you cannot use it, a physiotherapist can help. They can prepare a well-planned fitness regimen to help you avoid or delay an operation. A physiotherapist can educate you on how to relieve pain and regain movement.

Your personalized treatment plan can concentrate on improving your body posture or learning safe workouts for flexibility and strength. Healthy and secure joints need regular physical activity and strength exercises. A physiotherapist can develop a personalized exercise plan that meets your goals and needs.

You can also maintain the health of your joints with a balanced diet. Avoid using nicotine products or smoking. These are related to inflammation and could hinder the recovery process for any injury.

What Type of Physical Therapist Do I Require?

All certified physical therapists are trained and experienced in treating patients before and after shoulder replacement. You should consider a physiotherapist with experience working with patients who have musculoskeletal issues. A physical therapy facility focusing on sports medicine or orthopedic matters could also be a good fit for you.

You can also seek a qualified physiotherapist with post-professional training in a specific field, such as one of the following:

  • A therapist who has finished a residency course and spent over 1500 hours advancing their skills and expertise in a particular specialty area.
  • A physical therapist who has completed further education and has attained board certification in the fields of geriatrics, orthopedics, and sports medicine.
  • Completes a fellowship course and meets specific requirements. These professionals have extensive knowledge and competence in their respective fields. You should consider a professional with a fellowship in sports physical therapy, orthopedics, or geriatrics.

When searching for a physiotherapist or any other medical professional, you can consider the following:

  1. Seek referrals from friends, family members, and other healthcare professionals.
  2. When contacting a physical therapy facility for a scheduled appointment, inquire about the physiotherapist's experience working with patients suffering from shoulder pain or orthopedic issues.

How Long Does Therapy Last?

Physical therapy usually takes six to eight weeks for most patients who undergo a simple shoulder replacement. Every patient's rehabilitation journey is unique. While some can quickly achieve recovery goals, others would require more time.

Patients can usually expect to recover within twelve to sixteen weeks. You should work closely with your healthcare professional and a physical therapist so they can guide you through the specifics of your rehabilitation plan.

Find a Las Vegas Physical Therapy Center Near Me

If you or a loved one has undergone shoulder replacement, consulting with a physical therapist can help with the recovery process. Your shoulder arthroplasty rehabilitation will concentrate on assisting you in regaining strength and mobility to restore full, pain-free shoulder function. Working with a physical therapy professional can help you safely and quickly return to your regular job and leisure activities.

We at Suarez Physical Therapy offer effective treatment options for injuries impairing various body parts' mobility and functionality. If you require shoulder arthroplasty surgery in Las Vegas, we can assist you in recovering and maintaining a healthy lifestyle. Call us at 702-368-6778 to speak with one of our Las Vegas physical therapists.